Diagnostic value of contrast-enhanced ultrasound in the rupture of unstable carotid plaque in symptomatic ischemic stroke
Objective To explore the diagnostic value of contrast-enhanced ultrasound in the rupture of unstable carotid plaque in symptomatic ischemic stroke.Methods A total of 92 patients(111 plaques)with symptomatic ischemic stroke who were diagnosed and treated in our hospital from March 2021 to December 2022 were selected as the research objects.All patients underwent routine carotid ultrasound and contrast-enhanced ultrasound examination,and carotid endarterectomy was performed to obtain pathological results.The internal echo,surface morphology and neovascularization grading of plaques were compared between routine carotid ultrasound and contrast-enhanced ultrasound;the diagnostic efficacy of contrast-enhanced ultrasound in the diagnosis of unstable plaque rupture of carotid artery was analyzed with pathological diagnosis as the gold standard.Results A total of 24 uniform echoes and 87 uneven echoes in the plaques were detected by contrast-enhanced ultrasound,contrast-enhanced ultrasound was superior to routine carotid ultrasound in detecting the internal echoes of plaques(P＜0.001).Eighteen regular surface types,93 irregular surface types and ulcer plaque types were detected by contrast-enhanced ultrasound,contrast-enhanced ultrasound was superior to routine carotid ultrasound in the examination of plaque surface morphology(P＜0.001).Four neovascularizations of grade 0 and 107 neovascularizations of grade 1-3 in plaques were detected by contrast-enhanced ultrasound,contrast-enhanced ultrasound was superior to routine carotid ultrasound in detecting the grade of neovascularization in plaques(P＜0.001).Eighty-five cases of unstable plaque rupture were detected by pathology,and 81 cases of unstable plaque rupture were detected by contrast-enhanced ultrasound,which were in good agreement with pathological results(Kappa=0.826);the receiver operating characteristic(ROC)areas under curve(AUC)of contrast-enhanced ultrasound in the diagnosis of unstable plaque rupture was 0.899,and the sensitivity and specificity were 78.95％and 86.75％,respectively.Conclusion Contrast-enhanced ultrasound has a high diagnostic efficiency for unstable carotid plaque rupture in patients with symptomatic ischemic stroke.
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